Teens who send and receive sexually explicit texts or photos, colloquially known as “sexting,” are likely engaging in the same kinds of risky sexual behaviors offline, finds a new survey of Los Angeles high school students.

The recent survey of about 1,800 mostly Hispanic L.A. students, ages 12 to 18, found that teens who said they had sexted were seven times more likely to be sexually active than their peers who had never sent a naughty text. About three-quarters of surveyed teens had cell phones they used regularly; 15% had sexted and 54% said they knew someone who had. Kids who said their friends were sexting were 17 times more likely to sext themselves.

Although only a minority of teens engaged in sexting, those who did were not only more likely to be sexually active, but they also had higher chances of having unprotected sex during their last sexual encounter.

The findings suggest that teens are not necessarily using sexting as a safer alternative to real sex, as some previous data has indicated, which raises public health concerns about the link between digital sexual behavior and real-world risks of sexually transmitted infection and other risks.

“No one’s actually going to get a sexually transmitted disease because they’re sexting,” Eric Rice, the study’s lead researcher from the University of Southern California, in Los Angeles, told Reuters Health. “What we really wanted to know is, Is there a link between sexting and taking risks with your body? And the answer is a pretty resounding ‘yes.'”

Among the study’s participants, those most likely to sext were black teens and LGBT teens. The authors call on parents, doctors and educators to increase conversations about sexting with teens, but they highlight the importance of targeting these particularly higher-risk groups:

Engaging in such a conversation is applicable for adolescents of all sexual orientations; however, it may be even more important with sexual minority adolescents (LGBTQ), as these individuals are more likely to be engaging in both sexting and sexual risk behavior, yet feel less comfortable disclosing their sexual identity and behavior to providers. We encourage providers to not only connect with LGBTQ youth about sexting, but to also stress the importance of protected sex, given their added vulnerability to STIs and HIV.

Teens should also be reminded that photos and texts sent over cell phones can easily be made public on the Internet, opening them up to bullying and other risks, including criminal pornography charges. “Sexting may be particularly detrimental for adolescent populations because of the likelihood that sexually explicit material will be quickly shared throughout young people’s technologically active social groups,” the authors warned.

The authors recommend that schools add the topic of sexting to their sexual health-ed curriculum and that doctors use questions about sexting as a way to transition into other conversations about sexual activity.